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Contents
- Abstract
- Explanatory Theories
- Changes in Marriage: Implications for Theory
- Defining “Health”
- What Explains the Relationship Between Marital Quality and Health?
- Social-cognitive and affective processes
- Bidirectional associations with psychopathology
- Health behaviors
- Biological mediators
- Cardiovascular reactivity
- Neuroendocrine pathways
- Immune pathways
- The state of mediating mechanisms
- For Whom Might Marital Quality and Health Matter?
- What Is Not the Focus of the Meta-Analysis?
- Primary Research Aims
- Method
- Search Strategy
- Study Selection
- Independent variable: Marital quality
- Dependent variables: Health outcomes
- Dependent variables: Biological mediators
- Additional inclusion criteria
- Data Extraction
- Dependent samples in endpoint studies
- Multiple metrics in biological mediator studies
- Effect size extraction
- Data Analysis
- Moderators
- Theory-based moderators: Gender and gender inequality
- Methodology-related moderators
- Study design
- Marital quality construct validity
- Publication year
- Covariates and confounders
- Sensitivity analyses and publication bias
- Results
- Endpoint Studies
- Surrogate endpoints
- Publication bias
- Subjective clinical endpoints
- Publication bias
- Objective clinical endpoints
- Publication bias
- Moderator analyses
- Theory-based moderators: Gender and gender inequality
- Methodology-related moderators
- Marital quality construct validity
- Publication year
- Covariates and cofounders
- Sensitivity analyses
- Sample size and outliers
- Patient samples versus nonpatient samples
- Biological Mediator Studies
- Cardiovascular reactivity
- HPA axis function
- Discussion
- How “Big” Are These Effects, and What Is Their Practical Importance?
- What Outcomes Were Not Related to Marital Quality?
- Limitations of the Meta-Analysis
- Theoretical Implications
- Conceptualizing health
- Mediating mechanisms
- Social-cognitive/affective processes and marital distress-related psychopathology: Focusing on depression
- Health behaviors
- Biological mediators
- Moderators: For whom do these effects matter?
- Gender
- Age and cohort
- Individual differences
- Future directions in studying moderators
- Same-sex marriage
- Methodological Implications
- Marital quality measurement
- Study design
- Implications for Practice and Policy
- Prevention and promoting healthy marriages
- Clinical intervention and assessment
- Conclusion
Figures and Tables
Abstract
This meta-analysis reviewed 126 published empirical articles over the past 50 years describing associations between marital relationship quality and physical health in more than 72,000 individuals. Health outcomes included clinical endpoints (objective assessments of function, disease severity, and mortality; subjective health assessments) and surrogate endpoints (biological markers that substitute for clinical endpoints, such as blood pressure). Biological mediators included cardiovascular reactivity and hypothalamic-pituitary-adrenal axis activity. Greater marital quality was...